Systematic Review and Meta-analysis of En Bloc Vertebrectomy Compared with Intralesional Resection for Giant Cell Tumors of the Mobile Spine.

Abstract

<b>Study Design</b> Systematic review and meta-analysis. <b>Objective</b> To compare the recurrence and perioperative complication rate of en bloc vertebrectomy (EV) and intralesional resection (IR) in the giant cell tumor of the mobile spine (SGCT). <b>Methods</b> We systematically searched publications in the PubMed and Embase databases for reports of SGCTs, excluding the sacrum. Two reviewers independently assessed all publications. A meta-analysis was performed using local recurrence and postoperative complications as the primary outcomes of interest. <b>Results</b> There were four articles reporting recurrence and two articles reporting postoperative complications. All included articles were case series. In all, 91 patients were included; 49 were treated with IR and 42 were treated with EV. Local recurrence rates were 36.7 and 9.5% in the IR and EV groups, respectively. Rates of postoperative complications were 36.4% with IR and 11.1% with EV. Overall, patients treated with EV not only had a lower recurrence rate (relative risk [RR] 0.22; 95% confidence interval [CI] 0.09 to 0.52) but also had a lower postoperative complication rate (RR 0.34; 95% CI 0.07 to 1.52) compared with IR. <b>Conclusions</b> Based on the limited data obtained from systematic review, SGCT patients treated with EV had a lower recurrence rate and fewer postoperative complications than those treated with IR.